It has happened before. One of the survivors of the Boston Marathon bombing in 2013, James Costello, married his nurse, Krista D’Agostino, in Aug 2014. D’Agostino is a travel nurse who had cared for Costello for six weeks at a rehabilitation hospital following the bombing.

However, we should bear in mind that this is a perspective based more on Western norms, and may be rarer in Asian cultures like Singapore and Malaysia.

Ethical guidelines for various healthcare professionals

The most important question that must be asked is whether it is ethical. The answer is clear-cut in the case of patients still under the care of the medical professionals. Under the Code of Ethics and Professional Conduct for nurses and midwives, which replaces the previous Singapore Nursing Board Code of Conduct for nurses and midwives (1993), ‘indulging in inappropriate relationships with clients’ counts as professional misconduct.

According to the Ethical Code and Ethical Guidelines set forth by the Singapore Medical Council (SMC), ‘A doctor must not have a sexual relationship with a patient. This is to preserve the absolute confidence and trust of a doctor-patient relationship. A doctor must also not, as a result of his professional relationship, enter into an adulterous or any other improper association with the immediate members of the patient’s family.

Such a relationship would disrupt the patient’s family life and damage the relationship of trust between the doctor and his family. A doctor’s conduct must at all times be above suspicion.’

It is less straightforward in the case of relationships with former patients. On the one hand, both parties are human, so an adult relationship should be allowed. But on the other hand, there are several key issues to ponder:

“What is the length of time between the professional relationship and dating?”

“What kind of therapy did the patient receive? Assisting a patient with a short-term problem, such as a broken limb, is different than providing long-term care for a chronic condition.”

“Will the patient need therapy in the future?”

“Is there risk to the patient?”

Professional boundaries are important

Infidelity can be found anywhere regardless of culture, country or creed, but a recent survey by the “infidelity dating website,” Victoria Milan, has found that there are certain professions with more people who cheat on partners. It is as yet, unclear, whether the jobs themselves encourage infidelity, or that people predisposed to cheat are more likely to seek out these professions.

Interestingly, those working in the field of finance, such as brokers or bankers, are most likely to cheat. Following those in finance come those in the aviation field, healthcare, business, and sports. These results are based on a poll of more than 5,000 women who have or currently are cheating on their partners. The majority of women cheat at work because it is both easy and exciting. However, 85% regret the decision.

Moreover, cheating with a colleague increases the risk of getting caught, and makes it very likely that one has to associate with one’s ex-lover after parting ways. On the bright side, most women cite that having an inter-work affair did not affect their professional careers or their work performance.

A pamphlet released by the National Council of State Boards of Nursing states that “It is always the responsibility of a health care professional to establish appropriate boundaries with present and former patients.” Indeed, one cannot be blamed for developing attraction to someone; in fact, when it happens in a professional relationship, it is often a symptom of burnout.

Doctors given social media training to avoid romantic patient advances

The Medical Defence Union (MDU) in the UK says the rise of social media has led to doctors becoming "more accessible than ever" to patients who seek more than just a professional relationship. It has had to advice around 100 members in the last five years on how to handle this new problem.

"A handful of these involved the type of stalking behaviour where a doctor may need to involve the police. With doctors more accessible than ever via social media, amorous approaches from patients can feel intrusive,” explains Dr Beverley Ward, MDU's medico-legal adviser.

"Some patients create a fantasy affair to which the doctor is completely oblivious. Others can be very distressed if they feel their advances are being ignored or rejected, and they can become aggressive or vindictive,” she added.

The healthcare professional whose work has consumed his or her life may have few, if any, healthy relationships away from the office, and the intimacy of the doctor-patient relationship can begin to fill needs that should be filled elsewhere. The professional has to be aware of such vulnerabilities and guard against them. MIMS

Read more:
Doctors: How to end a professional relationship with a patient
4 things about a hospital's culture that can make or break employees
The 10 habits of a great doctor
7 ways to build a productive doctor-patient relationship